The use of transvaginal ultrasound in the diagnosis of ectopic pregnancy

Summary

Summary

A total of 160 patients were admitted with suspected ectopic pregnancies. Of these, 51 did not have raised serum or urinary hCG levels and were not pregnant. Of the 109 pregnant patients, 65 had ectopic pregnancies, 3 had heterotopic pregnancies and 41 had intra-uterine pregnancies.

Sixty-three patients with extra-uterine pregnancies had ultrasound scans, 8 by the abdominal route alone, and 55 with the vaginal probe. Two patients, one with a cornual and one with a heterotopic pregnancy were not diagnosed correctly on vaginal scanning.

The sensitivity of diagnosing ectopic pregnancy by one to three vaginal scans in pregnant patients was 96 per cent and the specificity was 100 per cent. The positive predictive value was 100 per cent and the negative predictive value was 92 per cent.

Vaginal scanning, when available, is the most informative investigation in patients with suspected ectopic pregnancy.